Peri-lunate dislocation and fracture-dislocation of the wrist: Retrospective evaluation of 65 cases

INTRODUCTION: Peri-lunate wrist dislocations and fracture-dislocations are related to high-energy trauma. Prognosis is often compromised because of the complexity of the lesions. The purpose of this study was to assess outcomes of acute peri-lunate injuries and correlate them with the type of lesion and management. MATERIEL AND METHODS: A monocenter retrospective study has been conducted. Sixty-five patients (65 wrists) were reviewed. According to Herzberg's classification, there were 18 isolated peri-lunate dislocations and 47 peri-lunate fracture-dislocations - 27 with a scaphoid fracture and 20 with an intact scaphoid. The displacement was dorsal in 62 cases. All patients were treated surgically. RESULTS: At an average follow-up of 8 years (2-16) the average Cooney score was 66 points, quick-DASH score 21 points, and PRWE score 28 points. Pain score was 1.3 out of 10 points at rest and 4.3 out of 10 with effort. The flexion-extension arc was 96° with an average strength of 38kg (70±23% of opposite side). Radiographic analysis has shown decrease in carpal height, increase in ulnar translation, and DISI. Sign of wrist arthritis was found in 58.5% of the cases. The rate of osteonecrosis was 7.7%. Regional sympathetic painful syndrome was observed in 12%. In 26% of the cases a secondary surgery was needed. No influence has been found with the final results between fracture-dislocation and isolated dislocation, and delay of treatment. Osteochondral lesions observed at surgery (P=0.035), osteonecrosis at follow-up (P=0.017), and modification of the scapho-lunate angle (P=0.029) were correlated with the occurrence of osteoarthritis. DISCUSSION: Peri-lunate dislocation and fracture-dislocation represent severe wrist trauma with often numerous sequelae with follow-up: pain, stiffness, loss of strength, carpal instability and arthritis. Early diagnosis and anatomic reduction are prerequisite to a satisfactory functional result. Capsulo-ligamentous lesions must be repaired and fractures must be fixed

US-guided Percutaneous Release of the Trigger Finger by Using a 21-gauge Needle: A Prospective Study of 60 Cases.

Purpose: To evaluate the efficacy of ultrasonographically (US)-guided percutaneous treatment of the trigger finger by releasing the A1 pulley with a 21-gauge needle. Materials and Methods : This two-part study was approved by the ethics committee, and written consent was obtained from all patients. The first part consisted of 10 procedures on cadaver digits followed by dissection to analyze the effectiveness of the A1 pulley release and detect any collateral damage to the A2 pulley, interdigital nerves, or underlying flexor tendons. The second part was performed during an 18-month period starting in March 2013. It was a prospective clinical study of 60 procedures performed in 48 patients. Outcomes were evaluated through a clinical examination at day 0 and during a 6-month follow-up visit, where the trigger digit was evaluated clinically and the Quick Disabilities of the Arm, Shoulder and Hand outcome measure, or QuickDASH, and patient satisfaction questionnaires were administered. Results : No complications were found during the cadaver study. However, the release was considered "partial" in all fingers. In the clinical study, the trigger finger was completely resolved in 81.7% (49 of 60) of cases immediately after the procedure. Moderate trigger finger persisted in 10 cases, and one thumb pulley could not be released. A US-guided corticosteroid injection was subsequently performed in these 11 cases. At 6-month follow-up, only two cases still had moderate trigger finger and there were no late complications. The mean QuickDASH questionnaire score was 4; all patients said they were satisfied. Conclusion : US-guided treatment of the trigger finger by using a 21-gauge needle is feasible in current practice, with minimal complications

Endomicroscopic image retrieval and classification using invariant visual features

International audienceThis paper investigates the use of modern content based image retrieval methods to classify endomicroscopic images into two categories: neoplastic (pathological) and benign. We describe first the method that maps an image into a visual feature signature which is a numerical vector invariant with respect to some particular classes of geometric and intensity transformations. Then we explain how these signatures are used to retrieve from a database the k closest images to a new image. The classification is finally achieved through a procedure of votes weighted by a proximity criterion (weighted k-nearest neighbors). Compared with several previously published alternatives whose maximal accuracy rate is almost 67 % on the database, our approach yields an accuracy of 80 % and offers promising perspectives

Generation of a single-cycle acoustic pulse: a scalable solution for transport in single-electron circuits

The synthesis of single-cycle, compressed optical and microwave pulses sparked novel areas of fundamental research. In the field of acoustics, however, such a generation has not been introduced yet. For numerous applications, the large spatial extent of surface acoustic waves (SAW) causes unwanted perturbations and limits the accuracy of physical manipulations. Particularly, this restriction applies to SAW-driven quantum experiments with single flying electrons, where extra modulation renders the exact position of the transported electron ambiguous and leads to undesired spin mixing. Here, we address this challenge by demonstrating single-shot chirp synthesis of a strongly compressed acoustic pulse. Employing this solitary SAW pulse to transport a single electron between distant quantum dots with an efficiency exceeding 99%, we show that chirp synthesis is competitive with regular transduction approaches. Performing a time-resolved investigation of the SAW-driven sending process, we outline the potential of the chirped SAW pulse to synchronize single-electron transport from many quantum-dot sources. By superimposing multiple pulses, we further point out the capability of chirp synthesis to generate arbitrary acoustic waveforms tailorable to a variety of (opto)nanomechanical applications. Our results shift the paradigm of compressed pulses to the field of acoustic phonons and pave the way for a SAW-driven platform of single-electron transport that is precise, synchronized, and scalable.Comment: To be published in Physical Review

Lysates of Methylococcus capsulatus Bath induce a lean-like microbiota, intestinal FoxP3+RORγt+IL-17+ Tregs and improve metabolism

Interactions between host and gut microbial communities are modulated by diets and play pivotal roles in immunological homeostasis and health. We show that exchanging the protein source in a high fat, high sugar, westernized diet from casein to whole-cell lysates of the non-commensal bacterium Methylococcus capsulatus Bath is sufficient to reverse western diet-induced changes in the gut microbiota to a state resembling that of lean, low fat diet-fed mice, both under mild thermal stress (T22 °C) and at thermoneutrality (T30 °C). Concomitant with microbiota changes, mice fed the Methylococcus-based western diet exhibit improved glucose regulation, reduced body and liver fat, and diminished hepatic immune infiltration. Intake of the Methylococcu-based diet markedly boosts Parabacteroides abundances in a manner depending on adaptive immunity, and upregulates triple positive (Foxp3+RORγt+IL-17+) regulatory T cells in the small and large intestine. Collectively, these data point to the potential for leveraging the use of McB lysates to improve immunometabolic homeostasis.publishedVersio

Conception et réalisation d'un vérificateur de modèles AltaRica

BORDEAUX1-BU Sciences-Talence (335222101) / SudocSudocFranceF

Avant-Propos

Albert Camus est né le 7 novembre 1913. Le 4 janvier 1960, il disparaissait dans un accident de la route. À peine le cinquantième anniversaire de sa mort a-t-il été commémoré qu’il faut penser, c’est ainsi, à célébrer le centenaire de sa naissance. C’est ainsi, dit-on, parce que cela ne va pas de soi. Et pourtant, entre ces deux dates, s’est écoulée toute une vie aussi normale, naturelle et quotidienne que n’importe quelle autre vie, avec ses affaires et ses devoirs quotidiens, ses angoisses ..

Rôle du facteur 4 plaquettaire dans la modulation de l'hémostase

Le facteur 4 plaquettaire (PF4) est un tétramère composé d'unités de 70 acides aminés contenu dans les granules a des plaquettes qui le sécrètent en grande quantité (10 à 25 g/ml) lors de l'activation. L'éventuelle fonction du PF4 dans l'hémostase reste ambiguë car des activités aussi bien pro- qu'anti-coagulantes lui ont été attribuées. Nous avons observé que le PF4 exerce un effet majeur sur la structure du caillot de fibrine. En étudiant la formation d'un caillot de fibrine en turbidimétrie et en microscopie électronique à balayage nous avons montré que le PF4 influence considérablement la polymérisation. Ainsi en se liant à la fibrine, le PF4 oriente l'assemblage des protofibrilles qui forment une nappe imperméable. Nous avons montré que le PF4 inhibait de façon dose-dépendante la génération de thrombine dans un plasma. Nous avons ègalement montré que le PF4 inhibe la formation du complexe prothrombinase en masquant le facteur V à son activateur, la thrombine. De façon surprenante, le PF4 s'est par ailleurs avéré être un puissant inhibiteur de l'agrégation plaquettaire. Nous proposons que le PF4, caractérisé par une très forte densité de charges positives, pourrait entrer en compétition avec la thrombine vis à vis des ligands de son exosite 1.Platelet factor 4 (PF4) is a tetrameric protein composed of four 70-amino-acid subunits that is contained in platelet a-granules. Large amounts of PF4 (up to 10-25 g/ml) are released upon platelet aggregation. The role of PF4 in hemostasis remains elusive as PF4 has been reported to possess procoagulant and anticoagulant activities as well. We have observed that PF4 exerts a major effect on the structure of the fibrin clot. By evaluating the formation of a fibrin clot by turbidimetric methods and by electronic microscopy, we have shown that PF4 has a considerable effect on the fibrin polymerization process. By binding to fibrin, PF4 thus drives the assembly of protofibrils which then form an impermeable network. In addition, we have demonstrated that PF4 dose-dependently inhibits the generation of thrombin in a plasma-based assay. Furthermore, we have shown that PF4 prevents the activation of factor V by thrombin, which results in inhibition of the prothrombinase complex. Surprisingly, PF4 is also a very potent inhibitor of platelet aggregation. We therefore propose that PF4, which contains a high density of positive charges exposed at its surface, might compete with thrombin towards various ligands of thrombin exosite 1, such as factor V, fibrinogen, PAR-1 (...).PARIS-BIUP (751062107) / SudocSudocFranceF

Rôle facilitant du contexte dans la pratique de l'imagerie motrice en tennis de table

Guillot Aymeric, Collet Christian, Dittmar André. Rôle facilitant du contexte dans la pratique de l'imagerie motrice en tennis de table. In: Les Cahiers de l'INSEP, n°35, 2005. Les sports de raquette. Données scientifiques et méthodologiques. Applications pour l'entraînement. pp. 107-118